European journal of anaesthesiology
-
Randomized Controlled Trial
The effect of transversus abdominis plane block or local anaesthetic infiltration in inguinal hernia repair: a randomised clinical trial.
The analgesic effect of transversus abdominis plane (TAP) block after inguinal hernia repair is unclear. ⋯ Ultrasound-guided TAP block did not reduce postoperative pain after inguinal hernia repair.
-
The scope of this review is to provide a pathophysiological summary of perioperative right ventricular function and failure. In recent decades, the importance of right ventricular function in the perioperative period has been established. However, much of our current knowledge on the management of this clinical entity is based on extrapolation of results from left ventricular research, although biventricular physiology is known to be markedly different in many aspects. ⋯ After underlining the importance of this topic, we review basic right ventricular anatomy and physiology, with an emphasis on the role of ventricular interaction. Next, potential causes of perioperative right ventricular failure are discussed. The emphasis of this review is on the perioperative anaesthetic considerations, ranging from preoperative assessment through intraoperative monitoring to specific contemporary therapeutic options of perioperative right ventricular failure.
-
Randomized Controlled Trial
Analgesic efficacy of ultrasound-guided adductor canal blockade after arthroscopic anterior cruciate ligament reconstruction: a randomised controlled trial.
Anterior cruciate ligament (ACL) reconstruction surgery is associated with moderate to severe postoperative pain, which may be ameliorated by peripheral nerve blocks. The adductor canal block (ACB) is an almost exclusively sensory nerve block that has been demonstrated to reduce pain and opioid consumption after major knee surgery. ⋯ An analgesic regimen with paracetamol and ibuprofen provides acceptable postoperative pain control after arthroscopic ACL reconstruction. ACB did not confer further benefit in our patients.
-
Pupillary reflex dilation appears to be a reliable indicator of response to noxious stimulation even under general anaesthesia. The ability of pupillometry to detect the effects of extremity blocks during continuous infusion of opioids remains unknown. ⋯ These results are a proof of concept. The effects of peripheral nerve block can be detected via the measurement of pupillary reflex dilation response to noxious stimulation of the skin in patients receiving remifentanil.